What does the NIHSS calculator measure?

It quantifies neurological deficit in acute stroke using 15 scored items across 11 categories.

What is the NIHSS score range?

The total ranges from 0 to 42, with higher scores indicating more severe neurological impairment.

How is the NIHSS score interpreted?

A score of 0 indicates no symptoms; 1–4 is minor, 5–15 moderate, 16–20 moderate-to-severe, and 21–42 severe.

Are left and right limb scores both included?

Yes. Left and right arm and leg motor findings are scored separately and included in the standard total.

Who should use this calculator?

NIHSS scoring should be performed by trained personnel because scoring reliability depends on examiner training and technique.

NIH Stroke Scale (NIHSS) | Online Free Tool

NIH Stroke Scale (NIHSS) | Online Free Tool | Elysia Tools

Examples

1. Right MCA syndrome with moderate-to-severe deficit

Stroke team clinician

Background

A patient presents with drowsiness, forced left gaze, complete left hemianopia, facial palsy, right-sided weakness, mild sensory loss, dysarthria, and partial neglect.

Problem

Calculate the NIHSS total and classify the severity of the neurological deficit.

How to use

Select the documented findings for consciousness, gaze, vision, facial palsy, right arm and leg weakness, sensation, dysarthria, and neglect; leave unaffected items at 0.

LOC 1; LOC questions 1; LOC commands 1; gaze 2; visual fields 2; facial palsy 2; left arm 0; right arm 2; left leg 0; right leg 2; ataxia 0; sensory 1; language 0; dysarthria 1; extinction/inattention 1.

Outcome

The calculator returns an NIHSS total of 16, classified as moderate-to-severe stroke, with the right side more affected.

2. Minor stroke with limited motor and sensory findings

Neurology trainee

Background

A patient is alert and oriented but has minor facial palsy, slight right arm drift, mild sensory loss, and partial inattention.

Problem

Produce a standardized score for a mild neurological deficit.

How to use

Enter 1 for facial palsy, right arm motor, sensory, and extinction/inattention, and select 0 for all other items.

LOC 0; LOC questions 0; LOC commands 0; gaze 0; visual fields 0; facial palsy 1; left arm 0; right arm 1; left leg 0; right leg 0; ataxia 0; sensory 1; language 0; dysarthria 0; extinction/inattention 1.

Outcome

The calculator returns an NIHSS total of 4, classified as a minor stroke.

NIH Stroke Scale (NIHSS)

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Key facts

Overview

When to use

How it works

Use cases

Examples

1. Right MCA syndrome with moderate-to-severe deficit

2. Minor stroke with limited motor and sensory findings

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